Look Backward to Plan Forward | North Carolina Employee Benefits

We have entered Open Enrollment season and that means you and everyone in your office are probably reading through enrollment guides and trying to decipher it all. As you begin your research into which plan to choose or even how much to contribute to your Health Savings Account (HSA), consider evaluating how you used your health plan last year. Looking backward can actually help you plan forward and make the most of your health care dollars for the coming year.

Check out these four things to look at as you go into Open Enrollment season!

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Is Your Health Plan Affordable for 2019? | North Carolina Benefit Advisors

The Affordable Care Act’s employer shared responsibility provision — often called the employer mandate or “play or pay” — requires large employers to offer health coverage to their full-time employees or face a potential penalty. (Employers with fewer than 50 full-time and full-time-equivalent employees are exempt.) Large employers can avoid the risk of any play or pay penalties by offering all full-time employees at least one group health plan option that meets two standards: It provides minimum value and it is affordable.

Minimum value means the plan’s share of total allowed costs is at least 60 percent and the plan provides substantial coverage of physician services and inpatient hospital services.

Affordable means the employee’s required contribution (payroll deduction) for self-only coverage, if elected, does not exceed a certain percentage of the employee’s household income. The affordability percentage changes slightly each year based on the law’s indexing rule. For 2018, the percentage is 9.56 percent. For 2019, however, the percentage increases to 9.86 percent.

Although the change is minor, it means that employers may increase their plan’s employee-only contribution rate and still meet the affordability standard next year.

Determining Affordability

The first step in determining whether a group health plan option is affordable is to define the employee’s “income.” Employers do not know their workers’ total household income, so the play or pay rules offer employers three optional safe harbor methods to define income using information known to the employer. Employers may use any of the safe harbor methods. They also may use different methods for different classes (such as one method for hourly employees and another method for salaried employees), provided that the chosen method is applied uniformly to all employees in the class.

The three IRS safe harbor methods are:

1. Federal Poverty Line (FPL)

The FPL method is the easiest of the three methods. Multiply the mainland FPL amount for a single-member household by the affordability percentage, then divide by 12. As long as the self-only contribution rate does not exceed the resulting amount, the plan’s coverage is deemed affordable. For instance:

  • 2018: ($12,060 x 9.56%)/12 = $96.08 per month

  • 2019: ($12,140 x 9.86%)/12 = $99.75 per month

The FPL chart is updated every year in late January. For 2019 calendar-year health plans, the employer needs to refer to the current FPL amount ($12,140) since the new FPL amount will not be available until after the plan year starts. If the health plan year starts February 1, 2018 or later, however, the employer may refer to the new FPL amount which likely will be a little higher.

2. Rate of Pay

This is the most convenient method to define income when applied to hourly employees. Multiply the employee’s hourly rate of pay times 130 hours per month (regardless of how many hours he or she actually works), then multiply by the affordability percentage. As long as the self-only contribution rate does not exceed the resulting amount, the plan’s coverage is deemed affordable. For instance:

  • 2018: ($11* x 130) x 9.56% = $136.70 per month

  • 2019: ($11* x 130) x 9.86% = $140.99 per month

* Replace $11 with the hourly employee’s rate of pay.

For salaried employees, the rate of pay method is somewhat complicated so employers generally avoid using this method for non-hourly employees.

3. W-2

The W-2 method requires using current W-2 wages instead of looking back at the prior year. W-2 wages means the amount that will be reported in Box 1 of Form W-2. Pretax contributions, such as § 125 plan contributions and 401(k) or 403(b) plan deferrals, are not included in Box 1, so using the W-2 safe harbor method may understate the employee’s actual income. Coverage will be deemed affordable if, for each month of the plan year, the self-only contribution does not exceed the Box 1 amount multiplied by the affordability percentage.

Summary

Large employers can avoid the risk of potential penalties under the ACA’s play or pay rules by ensuring that they offer full-time employees at least one minimum value plan option that also is affordable. Affordable means the employee’s contribution to elect self-only coverage would not exceed a certain percentage of the employee’s income.

The percentage used to determine affordability changes from year to year is based on the law’s indexing formula. For 2018 plan years, the affordability percentage is 9.56 percent, but it increases to 9.86 percent for 2019 plan years. Employers and their advisors will want to keep this information in mind as they finalize their group health plan offerings and employee contribution rates for 2019.

Originally published www.thinkhr.com

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Back to School Time Off Tips | North Carolina Benefit Advisors

The coals from the Labor Day barbecues have cooled, the beach chairs have been returned to their sheds, the ice cream shops have scaled back their hours, and the white shoes have been set aside for the next nine months. Whatever the end of summer means to you, for millions of families, it signals the return to school for children in preschool through college.

This means your employees will likely need to take a few hours out of their workday occasionally to participate in their children’s education. Parents’ fall calendars are often packed with school events, parent-teacher conferences, and/or parent meetings – some of which will inevitably occur during their usual working hours – and any flexibility you give them to attend these events, or even volunteer in the classroom or chaperone a field trip, will be greatly appreciated.

Where it’s the law

Nine states and the District of Columbia have passed laws protecting parents’ rights to take small increments of time away from work to attend to school matters. They vary widely in their specifics regarding eligibility for leave, whether the time is paid or unpaid, and the amount of time available for use. (ThinkHR customers can get details about each state’s provisions by clicking the act titles listed below after logging into to your ThinkHR account.)

Even if it’s not the law

It’s a best practice to offer flexibility to all employees so that they can meet the obligations of daily life while still performing at their peak at work. It goes a long way toward making an employee feel good about where they work when they can see their child perform in a school play, take their dog to the vet, or accept an appliance delivery without worrying about missing a couple hours of work or needing to take a full day off.

The beginning of fall is a great time to review your established time off policies to see how you can accommodate parents and guardians who need to meet school obligations as well as giving all employees the flexibility to attend to the other small necessities of life.

In many cases, your established policies may not need to change. Depending on the needs of your workplace, your state laws, and the employee’s position, this could mean allowing employees to make up a few hours of work, take an extended lunch period, shift their schedule to start earlier or later to still get a full day in, or use personal, vacation, or PTO time in small increments.

Originally published by www.thinkhr.com

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New Federal Contract Compliance Directives | North Carolina Employee Benefits

On August 24, 2018, the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) announced the following three directives:

  • Guidance for Contractor Compensation PracticesDirective 2018-05 clarifies the OFCCP’s approach to conducting compensation evaluations, supports compliance and compensation self-analyses by contractors, and improves compensation analysis consistency and efficiency during compliance evaluations.
  • Contractor Recognition Programs: Directive 2018-06 establishes a contractor recognition program with awards that highlight best practices, a contractor mentoring program, and other initiatives that provide opportunities for contractors to collaborate or provide feedback to OFCCP.
  • Affirmative Action Program Verification Initiative: Federal contractors are legally required to take steps to ensure equal opportunity in their employment processes, including developing a written affirmative action program within 120 days of when the contract begins. Directive 2018-07 establishes a program for verifying compliance with these and other affirmative action obligations.

The OFCCP enforces federal laws that prohibit federal contractors and subcontractors from discriminating on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. In addition, contractors and subcontractors are prohibited from discriminating against applicants or employees because they inquire about, discuss, or disclose their compensation or that of others, subject to certain limitations.

Originally published www.thinkhr.com

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Short-Term Limited-Duration Insurance – In a Nutshell | North Carolina Benefit Advisors

On August 3, 2018, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (the Departments) published a Final Rule to expand the availability of short-term medical policies. Called short-term, limited-duration insurance (STLDI), the policies are marketed to individuals as an alternative to ACA-compliant plans. Currently a short-term policy is limited to less than three months, but the new rule will allow carriers to issue the policies for longer periods.

What is short-term limited-duration insurance (STLDI)?

Short-term, limited-duration insurance is a specific type of health coverage that is exempt from the ACA’s market reform rules. STLDI policies may exclude entire categories of benefits, such as prescription drugs, maternity, or mental health care, may impose coverage caps, and may reject applicants with pre-existing conditions. STLDI policies offer lower premiums than ACA-compliant plans because they provide less coverage and typically only accept healthy applicants.

Note that STLDI is not minimum essential coverage and does not satisfy the ACA’s individual mandate. The individual mandate (i.e., the requirement for individuals to have some form of minimum essential coverage) expires at the end of 2018, after which persons without adequate health coverage will no longer be exposed to potential IRS tax penalties.

What is the purpose of the new federal rule?

The existing rule defines “short term” as less than three months and limits the policy’s duration by prohibiting renewals that would go beyond the three-month period. The new rule, on the other hand, will allow carriers to issue STLDI policies for an initial term of up to 364 days, and allows extensions or renewals for up a total of 36 months. This is a significant change that is intended to expand access to low-cost limited-coverage options for individuals.

The new federal rule takes effect for STLDI policies issued October 2, 2018, or later. There is a catch, however. Insurance is subject to state insurance laws, and many states appear reluctant to adopt the new rule for policies issued in their state. Some states even prohibit short-term policies under the current federal rule. At last weekend’s National Association of Insurance Commissioners (NAIC) meeting, several state regulators expressed concerns about “junk insurance” or deceptive marketing practices that may lure consumers into purchasing substandard coverage.

Are employers affected by STLDI policies or the new rule?

No.

Employers are not directly affected by STLDI policies. The policies are marketed to individuals, where permitted by state insurance law; they are not group plans.

Some workers may consider STLDI options, or ACA-compliant individual insurance options, as an alternative to their employer’s group plan. In most cases, though, persons who buy individual insurance do so because they do not have access to an employer’s plan. Workers whose employment ends may also consider individual options as an alternative to COBRA.

What’s Next?

Over the coming weeks and months, state insurance regulators and state legislatures are expected to review their existing laws and regulations on short-term, limited-duration insurance and consider whether to adopt changes. Some states likely will choose to implement rules to support the new federal rule, while other states certainly will impose restrictions or continue to prohibit the sale of insurance products they consider to be substandard.

Originally published by www.thinkhr.com

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DOL Updates the Employer CHIP Notice | North Carolina Employee Benefits

The U.S. Department of Labor (DOL) has updated the model notice for employers to use to inform employees about the Children’s Health Insurance Program (CHIP). All employers with group health plans are required to distribute a CHIP notice at least once a year to employees living in certain states. There is no need to send another notice to workers who received the prior version in the past year, but employers should use the updated notice going forward. This also is a good time for employers to review their procedures for distributing CHIP notices.

The following are the most frequently asked questions we receive from employers about CHIP notices.

Frequently Asked Questions

What is the purpose of the CHIP notice?
The CHIP notice informs benefits-eligible employees that their state’s CHIP or Medicaid program may offer premium assistance to help them pay for group health coverage at work. Many states offer some form of premium assistance to residents based on their family income. The updated notice includes contact information for each participating state (currently 37 states) and explains that persons approved for premium assistance have a special 60-day enrollment period to join their employer’s group plan without having to wait for the employer’s next annual enrollment period.

Does the CHIP notice requirement affect all employers?
All employers that offer a group health plan providing medical benefits, whether insured or self-funded, must consider the CHIP notice requirement. Each employer then will determine if it must distribute the notice depending on whether any of its employees live in one of the states listed in the notice.

Further, all group health (medical) plans must offer a special 60-day enrollment period when an employee becomes eligible for premium assistance (for the employee or a family member) from a state’s CHIP or Medicaid program.

Is the notice required for all employees or just for those enrolled in our group health plan?
The notice must be given to all employees living in any one of the listed states and eligible for the employer’s group health plan, whether or not currently enrolled. That is the minimum requirement. Many employers, however, choose to distribute the notice to all employees, regardless of benefits eligibility or location, to avoid the need for separate distributions when an employee’s status or location changes.

How do we prepare and distribute the notice? How often?
The DOL provides a model notice that employers can copy and distribute. Although employers have the option of creating their own notice to list only the states where their employees are located, most employers simply use the DOL model notice as it is. The model notice also is available in Spanish.

The notice must be distributed when employees initially become eligible for the employer’s health plan and then at least once a year thereafter. For convenience, most employers provide the notice at the same time as they distribute new hire materials and annual enrollment materials.

When combined with other materials, the CHIP notice must appear “separately and in a manner which ensures that an employee who may be eligible for premium assistance could reasonably be expected to appreciate its significance.” For instance, the notice may be a loose item in the same envelope with other material. If the notice is stapled inside other material, however, there should be a note on the top page or cover alerting the reader to the placement of the CHIP notice and its importance.

Do we have to mail out paper copies or can we distribute the notice electronically?
The notice may be sent by first-class mail. Alternatively, it can be distributed electronically if the employer follows the DOL’s guidelines for electronic delivery of group health plan materials. That means that the employer first must determine whether the intended recipient has regular access to the electronic media system (e.g., email) as an integral part of his or her job. If so, the notice can be sent electronically provided the employer takes steps to ensure actual receipt, along with notifying the employee of the material’s significance and that a paper copy is available at no cost.

For persons who do not have regular access to the electronic media system, the notice cannot be sent electronically unless the intended recipient provides affirmative consent in advance. The guidelines for obtaining advance consent are fairly cumbersome, so employers are advised to distribute paper copies in these cases.

Summary

Employers offering group health plans are encouraged to review their procedures for distributing CHIP notices. At a minimum, the notice must be given annually to all employees eligible for the employer’s health plan who live in any of the states listed in the notice. Many employers choose to distribute the notice to all workers in an abundance of caution. The DOL provides model notices in English and Spanish that do not need any customization, so employers can simply copy and distribute one or both versions as needed.

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Preparation Aids Prevention | North Carolina Benefit Advisors

Incidences of workplace violence are becoming more common and are all over the news. It’s not just high-profile headline cases that are a concern—it’s happening on a smaller scale in all kinds of businesses. Threats to workplaces can take many forms, from cyberbullying and workplace harassment to physical altercations and targeted violence.

The Occupational Safety and Health Administration (OSHA) estimates that every year nearly 2 million U.S. workers are victims of workplace violence, with a total economic cost of more than $55 billion. According to the most recent National Census of Fatal Occupational Injuries, violence in the workplace increased 23 percent between 2015 and 2016 to become the second-most common category of workplace fatalities, behind transportation incidents.

Assessing elements of risk that may trigger violence, along with developing a prevention plan, is critical.

While a bill has been recently introduced in Congress relating to workplace violence in the healthcare industry, and some states address workplace violence in their safety regulations, there are no specific OSHA standards for workplace violence at the federal level outside of the OSHA General Duty Clause. This clause requires employers to provide their employees with a place of employment that is “free from recognized hazards that are causing or are likely to cause death or serious harm.”

If your clients experience acts of workplace violence or become aware of threats, intimidation, or other indicators suggesting that the potential for violence in the workplace exists, OSHA and state programs would expect them to implement a workplace violence prevention program combined with controls and training.

The good news is, you can help arm your clients with strategies for reducing the risk of workplace violence this summer.

Prevention is key

Assessing elements of risk that may trigger violence, along with developing a prevention plan, is critical. This starts with a complete evaluation of the organization’s strengths, weaknesses, opportunities, and threats as they relate to the types of risks the organization might face. A review of the company’s strategic objectives and deliverables, the resources available to employees to accomplish these deliverables, and the physical layout of the facility are important elements to include in this evaluation.

Workplace violence preparation and prevention strategies

Hire right. Your clients’ businesses may be at risk due to the actions of their employees. Advise them to make good hiring decisions by clearly defining job requirements and thoroughly evaluating applicants. They should look carefully at resumes and job applications, probe gaps in applicants’ work histories, and verify education and work experience. Encourage them to conduct reference and background checks and be consistent with all applicants throughout the hiring process. That way, they can potentially avoid bad hires or negligent hiring claims.

Set clear expectations. When employees know what is expected of them, including behaviors important to the organization and performance standards, and those expectations are consistently enforced, they may experience less work-related stress and anxiety that can lead to hostility and violent outbursts.

Nurture an inclusive company culture. Studies show that in companies where employees feel like they are a part of the business and understand how their work contributes to the organization’s success, employees are more engaged and have more trust in their leaders and co-workers. Encourage your clients to focus on an inclusive culture built on strong values and it might result in fewer accidents, less absenteeism, and reduced risk for EPLI claims or workplace violence incidents.

Establish emergency preparedness plans. Advise your clients to develop emergency plans covering human-caused emergencies such as crime and violence, as well as hazards caused by natural disasters, outbreaks of disease, and accidents.

Establish safe reporting systems. Recommend that clients establish more than one method for employees to report any type of threat or issue that makes them feel unsafe in the workplace. These systems should include clear communication to employees that everyone is responsible for workplace safety, and there will be no retaliation for reporting safety concerns.

Provide workplace wellness programs. Some safety experts suggest that companies that demonstrate their commitment to their employees’ wellbeing through comprehensive wellness programs may reduce the risk of workplace violence. The rationale is that these programs help to defuse employee stress, anxiety, and unhealthy personal behaviors that can lead to violence.

Train, train, train. Every member of the team should be trained to know what to do in each type of emergency. In the case of workplace violence prevention, encourage your clients to train employees who have contact with the public about how to defuse potentially violent situations and protect themselves. Designate management team members to receive additional training to recognize the signs of employee distress — such as physical exhaustion, missing work commitments, more time out of the office, violent outbursts, isolating themselves from co-workers, or talking about hurting themselves or others — with the proper procedures for handling those situations. Well-trained team members who react quickly can save lives.

With the proper planning, systems, communications, and training, your clients can be better prepared to prevent or lessen the threats of workplace violence.

Originally published by www.thinkhr.com

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Wearable Technology | North Carolina Employee Benefits

Don’t lie--we ALL love gadgets. From the obscure (but hilariously reviewed on Amazon) Hutzler 571 Banana Slicer to the latest iteration of the Apple empire. Gadgets and technology can make our lives easier, make processes faster, and even help us get healthier. Businesses are now using the popularity of wearable technology to encourage employee wellness and increase productivity and morale.

According to a survey cited on Huffington Post, “82% of wearable technology users in American said it enhanced their lives in one way or another.” How so? Well, in the instance of health and wellness, tech wearers are much more aware of how much, or how little, they are moving throughout the day. We know that our sedentary lifestyles aren’t healthy and can lead to bigger health risks long term. Obesity, heart disease, high blood pressure, and Type 2 Diabetes are all side effects of this non-active lifestyle. But, these are all side effects that can be reversed with physically getting moving. Being aware of the cause of these problems helps us get motivated to work towards a solution.

Fitbit, Apple Watch, Pebble, and Jawbone UP all have activity tracking devices.  Many companies are offering incentives for employees who work on staying fit and healthy by using this wearable technology. For example, BP Oil gave employees a free Fitbit in exchange for them tracking their annual steps. Those BP employees who logged 1 million steps in a year were given lower insurance premiums. These benefits for the employee are monetary but there are other pros to consider as well. The data collected with wearable technology is very accurate and can help the user when she goes to her physician for an ailment. The doctor can look at this data and it can help connect the dots with symptoms and then assist the provider with a diagnosis.

So, what are the advantages to the company who creates wellness programs utilizing wearable technology?

·      Job seekers have said that employee wellness programs like this are very attractive to them when looking for a job.

·      Millennials are already wearing these devices and say that employers who invest in their well-being increases employee morale.

·      Employee healthcare costs are reduced.

·     Improved productivity including fewer disruptions from sick days.

The overall health and fitness of the company can be the driving force behind introducing wearable technology in a business but the benefits are so much more than that. Morale and productivity are intangible benefits but very important ones to consider. All in all, wearable technology is a great incentive for adopting healthy lifestyles and that benefits everyone—employee AND employer. 

 

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10 Stories That Caught Our Eye in June 2018 | North Carolina Benefit Advisors

Just Don’t Ask

Job candidates are covered by the Civil Rights Act prohibiting discrimination, and most interviewers know what kinds of direct questions to avoid. But what seems like a friendly conversation-starter could be an unwitting violation of the act. Read five questions you should never ask.

Read more on Namely.

Trust in Design

Office design is known to have an impact on employee productivity and satisfaction. At the heart of this is trust – trust that staff will choose to use the facility in the most effective way rather than be chained to their desks. And when trust rises, engagement follows.

Read more on Entrepreneur.

Pride Without Pandering

June was Pride Month, and corporations everywhere joined in the celebration. Some, although well-meaning, missed the mark. Seven LGBTQ executives explain how employers can embrace inclusion and celebrate diversity without coming across as pandering.

Read more on Fast Company.

Dad Days

Reddit cofounder Alexis Ohanian was a proponent of paternity leave and planned to lead by example by using his company’s benefit. However, he didn’t fully appreciate its importance until his daughter was born and he used the time off to slow down and take stock of his priorities.

Read more on CNN.

Culture Still Eats Strategy

Strategy is essential, but if a company doesn’t have a good culture, it won’t matter. Once you understand what culture is and isn’t, you can work toward developing a strong one, starting with defining the qualities you value in your employees.

Read more on Forbes.

Buy in Bulk

A rule released by the U.S. Department of Labor on June 19 loosens restrictions on association health plans, paving the way for more small businesses to band together to buy health coverage. That is, if it stands up to legal challenges, state laws, and the realities of the insurance marketplace.

Read more on Kaiser Health News.

The Family Friendly Workplace

Work-life balance can be especially challenging for parents. Both mothers and fathers lament not having enough time for their children. Get 10 creative ways you can make your workplace better for working parents.

Read more on Employee Benefit News.

Remote Control

The remote workforce continues to grow, but 57 percent of companies still lack a remote work policy. These companies may be missing out on attracting and retaining top talent. There’s no one-size-fits-all solution, with numerous factors to consider in crafting one.

Read more on HR Dive.

What Makes a Great Workplace

Inc. magazine surveyed thousands of employees to measure what employer qualities lead to high levels of employee engagement and sentiment, taking into account elements of corporate culture. See which of 45 perks and benefits employees value most.

Read more on Inc.

Run, Hide, Fight

Law enforcement officials stress the need for employers to conduct active shooter training to protect their employees and customers in the event of a violent incident. In addition to training, find out other ways to mitigate the risk a shooter or potential shooter holds.

Read more on Business Insurance.

Originally published by www.thinkhr.com

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The News about Association Health Plans | North Carolina Employee Benefit Advisors

On June 19, 2018, the U.S. Department of Labor released its Final Rule regarding Association Health Plans (AHPs). AHPs are not new, but they have not been widely available in the past and, in some cases, they have not been successful. The Final Rule is designed to make AHPs available to a greater number of small businesses as an alternative to standard ACA-compliant small group insurance policies.

This article answers common questions about AHPs under the current rules (which groups can continue to use) and the new rules.

Is group medical insurance the same for small and large employers?

Yes and no. Federal law imposes certain basic requirements on all group medical plans, regardless of the employer’s size. For instance, plans cannot exclude pre-existing conditions nor impose annual or lifetime dollar limits on basic benefits. If the plan is insured, it also is subject to the insurance laws of the state in which the policy is issued.

Small group policies, which are sold to employers with up to 50 or 100 employees, depending on the state, are subject to additional requirements. These policies must cover 10 categories of essential health benefits (EHBs), including hospitalization, maternity care, mental health and substance abuse treatment, and prescription drugs. (Some states allow certain grandfathered or grandmothered policy exceptions.) For most small employers, their options for group medical insurance are limited to small group policies that comply with the full scope of ACA requirements. On the other hand, the policies are subject to guaranteed issue and adjusted community rating rules, so carriers cannot refuse to insure a small employer nor use any past claims experience in setting rates.

Large group policies, which can only be sold to groups with at least 50 or 100 employees, depending on the state, are not required to cover all EHBs. Carriers have more flexibility in designing coverage options and developing premium rates in the large group market. This means larger employers have more options to choose from and may be able to purchase coverage at a lower cost than would apply to a small group policy. Note, however, that there is no guaranteed issue protection, so carriers can accept or reject each employer’s application or use the employer’s past claims experience in setting rates.

Lastly, self-funded plans are subject to the ACA and other federal laws, but generally are exempt from state laws. They typically are not feasible for small employers, however, due to the financial risk of uninsured programs.

What is an Association Health Plan (AHP)?

Group insurance covers the employees of an employer (or an employee organization such as a labor union). An AHP, as the name implies, covers the members of an association. Unrelated employers can obtain coverage for their employees through an AHP provided the employers form a bona fide association. Traditionally, this has meant that the employers had to have a “commonality of interest” and their primary interest had to be something other than an interest in providing benefits. For this reason, AHPs generally have been limited to associations formed by employers in the same trade, industry, or profession.

The Final Rule makes AHPs available to a wider range of businesses by expanding the meaning of “commonality of interest.” Once the Final Rule takes effect, an association may be formed by employers that are:

  • In the same trade, industry, or profession, regardless of location; or
  • In the same principal place of business; i.e., in the same state or in the same multi-state metropolitan area.

Under the new rules, the employer’s primary interest in associating may be benefits coverage, although they still will need to have at least one other substantial business purpose other than benefits. This is a key difference from the current rules.

When does the new Final Rule take effect?

The Final Rule expanding the definition of an association for purposes of an AHP will take effect on staggered dates:

  • For fully insured AHPs: September 1, 2018
  • For self-funded AHPs:
    • If in existence on or before June 19, 2018: January 1, 2019
    • If created after June 19, 2018: April 1, 2019

As noted, the new rules do not replace existing rules. Employers and associations may continue to follow the existing rules (which generally limit AHPs to employers in the same trade, industry, or profession). The new rules merely expand the opportunities for AHPs, such as making them available to employers in the same state or metropolitan area even if they are in different industries.

Are AHPs limited to employers with employees? What about sole proprietors?

Currently, sole proprietors, such as mom-and-pop shops without any W-2 employees, purchase medical insurance in the individual market. Individual policies often cost more than group policies or AHPs. The new rules will expand the availability of AHPs to include sole proprietors who work a minimum number of hours (so-called working owners).

What about state laws? Will AHPs be available nationwide?

Insurance products, including AHPs, are regulated by state law. Under both the existing and new rules, AHPs are multiple employer welfare arrangements (MEWAs). State laws on MEWAs are quite complicated. In some states, MEWAs are prohibited. In others, insured MEWAs are allowed but self-funded plans are prohibited. The laws vary from state to state, so different carriers will make different decisions about whether they want to design and market AHPs in various jurisdictions around the country.

A number of states are very concerned about AHPs and may prohibit them in their states or impose strict requirements to ensure they will provide reliable and effective coverage. Other states will view AHPs as cost-effective alternatives to ACA-compliant policies for small employers and look to encourage their expansion.

What’s next?

There is no clear answer to what’s next. Over the coming months, carriers across the country likely will review the reasons they have or have not offered AHPs in the past, and whether they want to consider new approaches in the future. Along with economic and market issues to consider, carriers also must consider the state insurance laws in different jurisdictions. At the same time, many state legislatures and insurance commissioners will be reviewing their existing rules and whether they want to promote or expand the availability of AHPs in their area.

Oh … and the lawsuits. Yes, that also is what’s next. As of this writing, attorneys general in different states are planning to join together in challenging the federal government’s Final Rule on AHPs. Their stated concern is that effective regulation is required to ensure that plans provide adequate coverage.

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6 Questions on Dependent Care Spending Accounts | North Carolina Employee Benefits

School’s out! Summer is here, and it’s the time of year when working parents have questions about using their Dependent Care Spending Accounts (DCSAs). Are summer camp expenses eligible? What about day versus overnight camps? Employers and benefit advisors want to be ready with answers about this valuable benefit program.

The following are the top summertime questions about DCSAs and reimbursable expenses:

1. What are the basic rules for reimbursable expenses?

Dependent care expenses, such as babysitting and daycare center costs, must be work-related to qualify for reimbursement. Work-related means the expenses are for the care of the employee’s child under age 13 to allow the employee to work. If the employee is married and filing jointly, the employee’s spouse also must be gainfully employed or looking for work (unless disabled or a full-time student).

In some cases, expenses to care for a disabled dependent, regardless of age, may be reimbursable. This article focuses on expenses for children under 13 since those are by far the most common type of DCSA reimbursement.

2. One of our employees and his family are taking a two-week vacation this summer, but his children’s daycare center will charge its regular fee. Are the expenses reimbursable even if the employee and spouse are off work?

Yes. In most cases, expenses are not eligible unless the dependent care services are necessary for the parents to work, but some exceptions apply. The IRS rules for DCSAs provide that expenses during short, temporary absences are eligible if the employee has to pay the child’s care provider. Absences of up to two weeks are automatically considered short, temporary absences. Depending on the circumstances, longer absences also may qualify.

3. During the school year, our employee uses her DCSA for her 10-year old’s after-school daycare center expenses. This summer, the child’s daycare will be provided by her 20-year old sister. If the older daughter bills for her services, are the costs eligible for reimbursement?

The answer depends on whether the employee or spouse can claim the older daughter as a tax dependent. If the older daughter can be claimed as a dependent, whether or not the employee actually claims her, she is not a qualifying dependent care provider under the DCSA rules.

If the older daughter cannot be claimed as a tax dependent, her charges for providing care are eligible expenses. The specific rule is that a child of the employee, whom the employee cannot claim as a dependent, may be a qualifying provider if the child is age 19 or older by the end of the year.

Note that the employee’s spouse or the child’s parent is never a qualifying provider.

4. One of our employees has to pay an application fee and deposit before her child starts attending a daycare center this summer. Are those expenses eligible for reimbursement?

Prepaid expenses are eligible for DCSA reimbursement, provided the costs are required in order for the child to receive care. In this case, after the daycare center begins providing care, the employee can be reimbursed for the application fee and deposit she paid. On the other hand, if the employee cancels and her child does not attend, then the application fee and deposit are not eligible expenses.

5. An employee will pay day camp expenses for his 8-year-old son and overnight camp expenses for his 12-year-old daughter this summer. Are both types of expenses eligible for reimbursement?

The day camp expenses generally are reimbursable. Expenses for overnight camp, however, are not eligible since overnight care is not work-related.

Under the IRS rules for DCSAs, expenses for food, lodging, clothing, education, and entertainment are not reimbursable. If, however, such expenses are small, incidental expenses that cannot be separated from the cost of caring for the child, they may be included for reimbursement. For instance, the day camp may include lunch, snacks, and some sports activities in its basic fee, which would be eligible for reimbursement.

6. An employee’s children go to private year-round schools. He pays tuition for one child’s grade school and fees for the other child’s nursery school. Are both types of expenses eligible for reimbursement?

Educational expenses are not reimbursable, unless the educational services are merely incidental as part of a child care service. Expenses to attend kindergarten or a higher grade are educational, so the older child’s school fees are not eligible for DCSA reimbursement. (Expenses for before- or after-school care, however, may qualify as reimbursable expenses.)

On the other hand, expenses for a child in nursery school, preschool, or a similar program for children below the level of kindergarten are expenses for care. Such expenses are not considered educational even though the nursery school may include some educational activities.

Originally published by www.thinkhr.com

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Price Shopping Health Care | North Carolina Benefit Advisors

As the costs of health care soar, many consumers are looking for ways to control their medical spending. Also, with the rise of enrollment in high deductible health plans, consumers are paying for more health care out-of-pocket. From medical savings accounts to discount plans for prescriptions, patients are growing increasingly conscious of prices for their healthcare needs. Price shopping procedures and providers allows you to compare prices so that you are getting the best value for your care.

Check out this short video to learn more!

Opioids in America | North Carolina Benefit Advisors

Lately, there’s been a big focus on America’s opioid addiction in the news. Whether it’s news on the abuse of the drug or it’s information sharing on how the drug works, Americans are talking about this subject regularly. We want to help educate you on this hot topic.

Opioids are made from the opium poppy plant.  Opium has been around since 3,400 BC and it was first referenced as being cultivated in Southwest Asia. The drug traveled the Silk Road from the Mediterranean to Asia to China. Since then, the drug has gained popularity for pain relief but it also has gained notoriety as an abused drug. Morphine, Codeine, and Heroin are all derived from the opium poppy and are all highly addictive drugs that are abused all around the world. As the demand for these drugs has increased, so has the production.  From 2016 to 2017, the area under opium poppy cultivation in Afghanistan increased by 63 percent. In 2016, it killed some 64,000 Americans, more than double the number in 2005.

We can see that the danger from this drug is growing rapidly. What can we do to recognize potential abuse problems and to get help? Here are some facts about opioid addiction:

·       How do they work? Opioids attach to pain receptors in your brain, spinal cord, and other areas that recognize pain signals. As they attach to the receptors, it reduces the sending of pain messages to the brain and therefore reduces the feelings of pain in your body.

·       Short-acting opiates are typically prescribed for injuries and only for a few days. They take 15-30 minutes for pain relief to begin and this relief lasts for 3-4 hours. Long-acting opiates are prescribed for moderate to severe pain and are used over a long period of time. Relief typically lasts for 8-12 hours and can be used alongside a short-acting drug for breakthrough pain.

·       Dependence is common with long-term use of an opiate. This means that the patient needs to take more of and higher doses of the medicine to get the same pain relieving effect. This does not necessarily mean the patient is addicted. Addiction is the abuse of the drug by taking it in an unprescribed way—like crushing tablets or using intravenously.

·       Americans account for less than 5% of the world’s population, but take 80% of the world’s opioid medications. About 5% of the people who take opiates become addicted to the drug.

·       Help is available through many channels from private recovery centers to insurance providers. The Substance Abuse and Mental Health Services Administration helpline is 1-800-662-HELP. This line is confidential, free, and available 24-hours a day and 7 days a week. Family and friends may also call this number for resources for help. Additional resources can be found at www.drugabuse.com.

Make sure you are educated about the dangers of opioid abuse. But, don’t be discouraged and think that the abuse is incurable! There are many resources that can be used to break the addiction cycle and can make real change in the lives of its victims. Ask for help and offer help.

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Top 5 Social Media Tips That Can Benefit Every Agency | North Carolina Employee Benefits

The world is connected nowadays through our screens. Whether it be email, texting, websites, Facetime, or social media; we all use technology to connect us to others. According to Hubspot, an online marketing and sales software provider, consumers are on social networks more than ever before. They wrote:

In our survey of 1,091 global internet users, we’ve found people have dramatically increased content consumption on the three most popular social networks in the last two years: Facebook (+57% increase), Twitter (25% increase), and LinkedIn (21% increase). These networks have notably doubled down on content in the past few years to capture and retain the attention of their users -- and it appears the playbook is working.The Future of Content Marketing: How People Are Changing the Way They Read, Interact, and Engage With Content

So, how do you harness this tech to strengthen your connectivity to your audience? Here’s the top 5 tips for using social media that every agency can benefit from using. 

1.     Consistent Content Posting

Your followers want to know when they can expect new info to be posted on your website and social media. If you post once a week for 3 weeks and then not post again for another month, your audience will quit paying attention. Consistency is the key! Mke a point to post at the same general time on the same days and you will see more interaction from your followers.

2.     Images & Videos

62% of users thoroughly consume the social media post if it includes video as compared to only 25% consumption of traditional long content posts. That’s a HUGE difference! Grab your audience’s attention when they are scrolling through their social media by posting pictures and videos. They are telling us that they will stop and watch or read more than skimming because of the images they see.

3.     Keep Up with Social Media Trends

Pay attention to what you are most engaged with on social media. Do you like to watch Facebook Live videos? Do you stop and scroll through pictures from companies when they post what they are doing in the community? Do you prefer to chat with a customer service representative online versus an email? If you are seeing your preferences change, there is a good chance your audience’s preferences are changing. Post pictures of your teams serving their community. Use videos to educate your clients on relevant issues in your field. Social media is constantly evolving so stay up on trends and use them on your pages!

4.     Facebook is Still King

Consumers are using Facebook for more than just connecting to their high school friends—they are using it to read content from their favorite businesses and groups. This means you MUST keep your Facebook page updated and have new content posted regularly. According to a new Hubspot survey, 48% of consumers use their Facebook feed to catch up on news, business, and lifestyle stories. This ties back to Tip #1 and reiterates that consistent posting is the sweet spot for engaging customers.

5.     Engage Your Audience

How are you talking to the people who use your business? Are you responding to inquiries on Facebook? When you post pictures on LinkedIn are you responding to the people who are looking and commenting on them? When you engage with your followers, they are more likely to have a stronger relationship with you. Entrepreneur Magazine says, “They are more likely to have a better evaluation of the brands, stay loyal to the brands and recommend the brands to others.”

By following these tips, your social media pages can grow into healthy sites and you can be more effective as you engage with your audience.  Start using them today!

 

 

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Benefits of an Annual Exam | North Carolina Employee Benefits

Becoming a well-informed patient who follows through on going to their annual exam, as well as follows the advice given to them from their physician after asking good questions, will not only save your budget, but it can save your life!

Check out this short video so you too, can be a well informed patient!

 

Discount Drug Programs | North Carolina Benefit Advisors

Did you know that you can save time and money on your prescription drugs by simply signing up for a discount card online? With savings as much as 80% off, these discount cards keep your health care costs down even when the prices of prescriptions are sharply rising.  At no cost to the patient, discount drug programs negotiate the price of medicines with pharmacies and then pass the savings on to the consumer.  These programs give subscribers a personalized discount card to be used at any pharmacy. While the discount card cannot be used in conjunction with health insurance, the consumer may see that the cost of their medicine is actually LESS with the card than it is with their insurance.

Another benefit to the consumer is that these programs will publish at which pharmacy you can find your medicine. This is especially helpful to the person who has specialty drug prescriptions. For example, Rebekah is prescribed a specialty drug for pain and neuropathy due to Multiple Sclerosis. This drug is not commonly stocked in pharmacies and so many times, she has had to wait for them to order it. By using the discount drug program, Rebekah is able to see which pharmacies have her medicine in stock and the estimated price.

So where do you start? Here are a few discount drug programs to investigate costs and providers for your prescriptions:

·      Provides free drug cards to reduce the out-of-pocket cost of prescription drugs.

·      Click on your state and the site will redirect you to your corresponding prescription assistance program.

·      Compares prices and discounts at thousands of pharmacies.

·      Receive coupons via phone, email, or text to print or present for discounts.

·      Free drug card to present at pharmacy for cost savings on prescriptions.

·      Earn rewards each time you use their card—similar to credit card rewards. Each fill is 500 points and when you reach 5,000 points, you earn a gift card to various retailers.

Being a savvy consumer can save you money! Shop around to find the best cost for your prescription drugs and save time by locating the pharmacy that has your meds in stock. Discount drug programs are a great resource so do your research and find one that fits your needs.

 

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